Of course, the newlyweds were shocked at the diagnosis.Neither had ever heard of any of these maladies before,and the situation was presented as extremely serious. “Thesurgeon told us that it was a very dangerous operation,”she said. “He asked if we had a will, but we’d only beenmarried four months. It is very hard to discuss end-of-lifewishes when you are just beginning a marriage. Theywanted to schedule the surgery right away, but I asked for aElizabeth has the genes for heart disease. She lost herparents 11 months apart in 2004 and 2005: her father toheart failure and her mother to a hemorrhagic stroke afterfour years of vascular dementia. Both had undergoneopen-heart surgery in their younger years, as had her olderbrother who is now deceased. Her younger brother hasundergone two stent operations. One was last year after anear fatal STEMI (heart attack).

Elizabeth had to be tested for coronary artery disease
(CAD), which often co-occurs with PAD. If they found
CAD, she would have to have a coronary bypass before
undergoing the aortobifemoral bypass, which involved both
the abdominal aorta and both femoral arteries. Fortunately,
she did not have CAD.

“It was a horrendous surgery” she said. “I was cut frommy breast bone to my pubic bone plus two incisions at thetop of each leg. They literally have to remove your organsand lay them to the side so they can work on your aortaand then place them back. The surgery took approximatelyseven hours. I have had surgery many times in my life forother conditions, and there is no comparison to the pain ofthe recovery from this one. If they told me I had to undergoit again, I would more than likely say no or look to other,newer options.”The vascular surgeon told her and husband, Stephen,that she would be “like new,” but that is not how it turnedout. “We assumed I would have no more pain and be ableto do what I wanted,” she said. “After the surgery I stillhad leg pain and then there were additional issues createdby the surgery itself due to nerve damage. My cardiologisteventually told me that I would never be much better thanbefore the surgery. The purpose of the surgery, he said, wasto save my legs, and quite possibly my life.”This news devastated her as she contemplated thepossibility of living life as an invalid. Her quality of lifehas been severely affected. She can no longer walk more

Elizabeth had classic PAD symptoms
— pain in the lower extremities, muscle
cramping in the hips, thighs or calves
when walking, climbing stairs or
exercising. This pain goes away in a
few minutes after you stop exercising.
This is because working muscles need
more blood flow; resting muscles can
get by with less. The “crampy” pain
(called “intermittent claudication”),
when caused by PAD, is the muscles’
way of warning the body that they
aren’t getting enough blood to meet the
increased demand of exercise.

Other symptoms of PAD include:• Leg pain that does not go awaywhen you stop exercising• Foot or toe wounds that won’t healor heal very slowly• Gangrene, or dead tissue• A marked decrease in thetemperature of your lower leg orfoot particularly compared to theother leg or to the rest of your body• Poor nail growth on the toes or hairgrowth on the legs• Erectile dysfunction, especially inmen with diabetes

See our infographic to help identifysymptoms and risk of PAD.

“The purpose of
the surgery, he
said, was to save
my legs, and quite
possibly my life.”